Medical lead with flexible distal guidewire extension

• US 20040064172A1
• Filed: 09/26/2002
• Published: 04/01/2004
• Est. Priority Date: 09/26/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: McVenes, Rick D., Stokes, Kenneth B.
• Granted Patent: US 7,313,445 B2
• Time in Patent Office: Days
• US Class Current: 607/122
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

An implantable medical lead is provided with a distal guidewire extension. A flexible distal guidewire extension, which may take the form of a helically wound wire around a tapered core, extends from the distal end of a lead body. The extension may exit a tip electrode, which may be a generally rounded electrode or an active fixation electrode. The distal guidewire extension is preferably insulated, but may be provided with an uninsulated segment for serving as an electrode.

Claims

1. An implantable cardiac vein lead adapted to be advanced through twists and turns of a cardiac vein and branch vessel openings to locate at least one electrode at an implantation site comprising:

an elongated lead body extending between a lead body proximal end and a lead body distal end and having a lead body axis, the lead body further enclosing at least one electrical conductor extending between a proximal lead connector element of the lead body and a distal electrode of the lead body adapted to be implanted in contact with a cardiac vein at an implantation site; and

an elongated flexible distal guidewire extension affixed to and extending from the lead body distal end to a distal guidewire extension distal tip and having a pre-formed bend formed along the length of the distal guidewire extension that disposes the distal guidewire extension distal tip lead laterally away from the lead body axis to enable aiming of the distal guidewire extension through twists and turns of a cardiac vein and branch vessel openings.

2. The cardiac vein lead of claim 1, wherein the distal guidewire extension has a first extension diameter at the lead body distal end and is tapered along the length of the distal guidewire extension to a second extension diameter at the distal guidewire extension distal tip.

3. The cardiac vein lead of claim 2, wherein the pre-formed bend is a bend of about 45°

.

4. The cardiac vein lead of claim 3, wherein the distal guidewire extension comprises a wire coil.

5. The cardiac vein lead of claim 3, wherein the distal guidewire extension comprises a wire coil covered by an electrically insulating material.

6. The cardiac vein lead of claim 1, wherein the distal guidewire extension comprises a wire coil or braid.

7. The cardiac vein lead of claim 1, wherein the distal guidewire extension comprises a wire coil or braid covered by an electrically insulating material.

8. The cardiac vein lead of claim 1, wherein the distal guidewire extension comprises a wire coil or braid electrically coupled with the electrical conductor to function as the distal electrode.

9. The cardiac vein lead of claim 8, wherein a proximal segment of the wire coil or braid of the distal guidewire extension is electrically insulated, and a distal segment of the wire coil or braid is exposed to function as the distal electrode.

10. The cardiac vein lead of claim 1, wherein:

the distal guidewire extension comprises a wire coil or braid; and

the lead body encloses a further electrical conductor extending between a further proximal lead connector element and the wire coil or braid, whereby the wire coil or braid functions as a further distal electrode.

11. The cardiac vein lead of claim 10, wherein a proximal segment of the wire coil or braid of the distal guidewire extension is electrically insulated, and a distal segment of the wire coil or braid is exposed to function as the further distal electrode.

12. The cardiac vein lead of claim 1, wherein the lead body further comprises a distal fixation mechanism adapted to affix the lead body distal end at the implantation site.

13. The cardiac vein lead of claim 1, wherein the lead body further comprises a distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue.

14. The cardiac vein lead of claim 1, wherein:

the lead body further comprises a distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue, the distal fixation helix having a helix lumen; and

the elongated flexible distal guidewire extension is affixed to the lead body distal end and extends distally through the helix lumen.

15. The cardiac vein lead of claim 1, wherein:

the lead body further comprises an electrically conductive distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue; and

the lead body encloses a further electrical conductor extending between a further proximal lead connector element and the fixation helix, whereby the fixation helix functions as a further distal electrode.

16. The cardiac vein lead of claim 1, wherein the lead body further comprises an electrically conductive distal fixation helix electrically coupled with the electrical conductor to function as the distal electrode and adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue.

17. The cardiac vein lead of claim 1, wherein the lead body further comprises a passive fixation mechanism located at the lead body distal end adapted to engage the cardiac vein at the implantation site.

18. The cardiac vein lead of claim 1, wherein the lead body further comprises a plurality of soft, pliant tines located at the lead body distal end adapted to engage the cardiac vein at the implantation site.

19. The cardiac vein lead of claim 18, wherein the lead body further comprises a monolithic controlled release device (MCRD) that swells in the presence of fluids in the cardiac vein and biases the plurality of tines outward.

20. The cardiac vein lead of claim 19, wherein the MCRD elutes antiinflammatory agents over time.

21. The cardiac vein lead of claim 18, wherein the plurality of tines further each comprise a monolithic controlled release device (MCRD) that elutes anti-inflammatory agents over time.

22. The cardiac vein lead of claim 1, wherein the distal guidewire extension comprises a shape memory alloy wire that functions as a distal fixation mechanism.

23. An implantable cardiac vein lead adapted to be advanced through twists and turns of a cardiac vein and branch vessel openings to locate at least one electrode at an implantation site comprising:

an elongated lead body extending between a lead body proximal end and a lead body distal end and having a lead body axis, the lead body further enclosing at least one electrical conductor extending between a proximal lead connector element of the lead body and a distal electrode of the lead body adapted to be implanted in contact with a cardiac vein at an implantation site;

an elongated flexible distal guidewire extension affixed to and extending from the lead body distal end to a distal guidewire extension distal tip to enable advancement of the lead body distal end and electrode to the implantation site through twists and turns of cardiac veins; and

a distal fixation mechanism adapted to affix the lead body distal end at the implantation site.

24. The cardiac vein lead of claim 23, wherein the distal fixation mechanism comprises a distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue.

25. The cardiac vein lead of claim 23, wherein:

the distal fixation mechanism comprises a distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue, the distal fixation helix having a helix lumen; and

the elongated flexible distal guidewire extension is affixed to the lead body distal end and extends distally through the helix lumen.

26. The cardiac vein lead of claim 23, wherein:

the distal fixation mechanism comprises an electrically conductive distal fixation helix adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue; and

the lead body encloses a further electrical conductor extending between a further proximal lead connector element and the fixation helix, whereby the fixation helix functions as a further distal electrode.

27. The cardiac vein lead of claim 23, wherein the distal fixation mechanism comprises an electrically conductive distal fixation helix electrically coupled with the electrical conductor to function as the distal electrode and adapted to affix the lead body distal end at the implantation site by rotation of the fixation helix into cardiac tissue.

28. The cardiac vein lead of claim 23, wherein the distal fixation mechanism comprises a passive fixation mechanism located at the lead body distal end adapted to engage the cardiac vein at the implantation site.

29. The cardiac vein lead of claim 23, wherein the distal fixation mechanism comprises a plurality of soft, pliant tines located at the lead body distal end adapted to engage the cardiac vein at the implantation site.

30. The cardiac vein lead of claim 29, wherein the lead body further comprises a monolithic controlled release device (MCRD) that swells in the presence of fluids in the cardiac vein and biases the plurality of tines outward.

31. The cardiac vein lead of claim 30, wherein the MCRD elutes anti-inflammatory agents over time.

32. The cardiac vein lead of claim 29, wherein the plurality of tines further each comprise a monolithic controlled release device (MCRD) that elutes anti-inflammatory agents over time.

33. The cardiac vein lead of claim 23, wherein the distal guidewire extension comprises a shape memory alloy wire that functions as the distal fixation mechanism.